Healthcare Provider Details

I. General information

NPI: 1407530033
Provider Name (Legal Business Name): TAREK SLIBI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 S MICHIGAN AVE
CHICAGO IL
60616-2315
US

IV. Provider business mailing address

1162 TYLER LN
UPLAND CA
91784-9280
US

V. Phone/Fax

Practice location:
  • Phone: 312-702-6290
  • Fax:
Mailing address:
  • Phone: 714-931-0220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA208470
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125082631
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: